My Patient Rights can help guide you in resolving issues so you can get the health care you deserve.
In a victory for Californians, Governor Gavin Newsom signed Senate Bill 600 (Portantino) to ensure health plans cover fertility preservation for patients undergoing medical treatments that can compromise their ability to become pregnant, such as chemotherapy. This new law confirms that fertility preservation is medically necessary for Californians at risk of losing their fertility due to side-effects associated with the treatment of cancer and other serious illnesses. In addition, this clarification should l prevent insurance providers from inappropriately denying coverage. Joyce Reinecke, executive director of the Alliance for Fertility Preservation highlights why the signing of SB 600 is significant by stating that “[t]his law gives patients access to the services that they need – and are entitled to – to protect their ability to have children after cancer. It gives the hope for their future’.
Although the California Department of Managed Health Care (DMHC) requires health plans to cover fertility preservation as a basic health care service, thousands of young adults in the state have received denials when trying to access this patient right. The DMHC even took action against unlawful denials by insurance plans including an Order of Cease and Desist against Kaiser Foundation Health Plan, Inc. for providing misinformation to patients on lack of coverage for this service.
Health plan denials have led to unnecessary anxiety and stress for patients like Emily Greenfield, a doctoral student at Stanford who learned of this coverage barrier shortly after receiving a breast cancer diagnosis. While she was initially told that her insurer would not cover fertility preservation, Emily eventually received partial coverage for the service. She considers herself lucky compared to other young women who might not know to appeal, and applauds the signage of SB 600, saying “we need to ensure all Californians know they have a right to coverage – and that insurance companies honor that right. SB 600 is a critical step toward achieving those goals.”
Additionally, SB 600 will ensure patients without the means to pay out-of-pocket costs for this service are not left to find funding on their own. Jessica Marin of Sacramento was forced to quickly raise funds from family, friends and the assistance of nonprofit cancer charities to cover fertility preservation before she started cancer treatment, due to unlawful coverage denial. Her appeal led to her health plan ultimately reimbursing her for the cost, but not every patient can self-fund preservation treatment or delay cancer care while fighting their insurers for the right to have a family.
Fortunately, due to the work of many advocates in the state, consumers in California undergoing major medical treatments will no longer have to choose between good health and having a family.
At My Patient Rights, we have heard countless stories about coverage denials from health plans, and patients failing to get the care they need, when they need it. We encourage patients to appeal denials with their insurance company, and are here to help along the way. Visit our website to learn more about how to file a complaint, and what steps you can take today to fight back.
My Patient Rights can help guide you in resolving issues so you can get the health care you deserve.
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State and federal law protects your rights. When you sign up for a health plan and/or if you have problems accessing care through your health plan, it is important to know your rights.